Anterior Cranial Base CSF Leaks and Encephaloceles
Anterior Cranial Base CSF Leaks and Encephaloceles Services
At Spokane ENT, we provide specialized care for anterior cranial base cerebrospinal fluid (CSF) leaks and encephaloceles. These conditions involve defects in the skull base—including the sphenoid sinus, ethmoid roof, and cribriform plate—through which brain tissue or meninges may herniate and cerebrospinal fluid may escape into the nasal cavity. Causes include idiopathic (spontaneous) defects, trauma, prior surgery, or congenital factors. Untreated CSF leaks can lead to recurrent meningitis and serious complications, making prompt diagnosis and repair essential.
Our evaluation includes detailed history, nasal endoscopy, and advanced imaging such as high-resolution CT and MRI. We may obtain fluid samples for beta-2 transferrin testing to confirm the presence of CSF. Precise localization of the defect guides our surgical approach. For most anterior cranial base CSF leaks and encephaloceles, we perform endoscopic endonasal repair, which avoids external incisions and allows multilayered closure of the defect using tissue grafts and sealants.
We collaborate closely with Inland Neurosurgery and Spine for complex cases requiring combined ENT and neurosurgical expertise. Our goal is to achieve durable repair, prevent recurrence, and minimize the risk of meningitis. Following surgery, we provide comprehensive postoperative care and monitoring to ensure optimal healing.
Anterior Cranial Base Partners
Frequently Asked Questions
A CSF leak at the anterior cranial base occurs when cerebrospinal fluid escapes through a defect in the skull base (sphenoid, ethmoid, or cribriform) into the nasal cavity. It can cause watery nasal drainage and increase the risk of meningitis.
An anterior skull base encephalocele is a defect where brain tissue or its covering protrudes through an opening in the anterior skull base into the nasal cavity. It may be congenital or acquired and can be associated with CSF leaks.
Most anterior cranial base CSF leaks and encephaloceles are repaired using endoscopic endonasal techniques through the nose. A multilayered closure closes the defect. Complex cases may involve collaboration with neurosurgeons.
Symptoms may include clear, watery nasal drainage (especially when leaning forward), salty taste, positional headaches, or recurrent meningitis. See an ENT if you have these symptoms.
Seek evaluation if you have persistent clear nasal drainage, especially after head trauma or surgery, or recurrent bouts of meningitis. Prompt diagnosis and repair reduce the risk of serious infection.